90年代急性风湿热的特点  

Clinical characteristics of acute rheumatic fever in 1990′

作　　者：黄建林[1] 余步云[1] 吴玉琼 陈国庆[1] 

机构地区：[1]中山医科大学附属第三医院风湿内科,广州510630

出　　处：《中华风湿病学杂志》2000年第5期284-286,共3页Chinese Journal of Rheumatology

摘　　要：目的　了解 90年代急性风湿热的特点。方法　选择 1990年 1月至 1999年 1月有详细病史、完整的体格检查和实验室检查资料的初发性急性风湿热 (ARF)病例 ,观察其主要临床表现和实验室检查结果 ,并与 5 6例 80年代初发ARF病例作比较。结果　① 77例初发性ARF中典型病例组 (A组 ) 2 4例 ,不典型ARF组 (B组 ) 5 3例 ;② 90年代病例组关节痛、关节炎出现率较 80年代组增多 ;而心脏炎出现率降低。③A组关节痛、心脏炎的出现率较B组高 ,但B组心脏炎的严重程度较A组为明显。结论　①初发ARF病例中不典型病例较典型病例的比例增高 (2∶1)。②ARF初发年龄有继续增大的趋势。③关节炎 /痛成为ARF的主要临床表现。关节痛、心脏炎在典型病例组出现率较高 ,但心脏受累的严重程度以不典型ARF组为明显 ,表现在心功能方面较为低下。④传统实验室检查 ,如ESR、ASO阳性率下降 ,新的特异性诊断方法PCA具有较高的临床意义。Objective To investigate the clinical characteristics of acute rheumatic fever in 1990′ so as to enhance the knowledge in early diagnosing.Methods The clinical data of 77 patients with initial attack of acute rheumatic fever in authors′ Hospital were reviewed retrospectively,and compared with the data of 1980'in this field.Results ① Twenty-four patients had typical manifestations of ARF,and 53 had atypical manifestations;②Arthralgia and carditis in typical cases were more common than that in atypical cases,but carditis in atypical cases were more seriously than that in typical cases.Conclusion ① The proportion of atypical cases is higher than that of typical cases (2∶1);②The patients tend to be more apparent with increasing age of initial attack;③Joint involvements become more common,and incidence of carditis decreases;④ The positive rate of traditional laboratory tests (such as ASO,ESR) becomes low,and new immunological test should be applied in order to early diagnose.

关 键 词：风湿热 回顾性研究 症状 病理学 急性 

分 类 号：R593.2[医药卫生—内科学]